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dintine sensitivity

dintine sensitivity. LI RUI DEPARTMENT OF PREVENTIVE DENTISTRY. Contents. 1 Conception. 2 Causes and pathology. 3 Diagnosis and treatment. conception. d entin sensitivity has been defined as “a short sharp pain arising from exposed dentin

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dintine sensitivity

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  1. dintinesensitivity LI RUI DEPARTMENT OF PREVENTIVE DENTISTRY

  2. Contents 1 Conception 2 Causes and pathology 3 Diagnosis and treatment

  3. conception dentin sensitivity has beendefinedas “ashortsharp pain arising fromexposeddentin inresponse to stimulitypically thermal, evaporative,tactile,osmotic or chemical and which cannot beascribedto any other form of dental defector pathology.” (Addy,1983)

  4. Etiopathogenesis The hydrodynamic theory is the most widely accepted physiopathological theory of DS (Brannstrom,1972) stimuli→centrifugal fluid flow within the dentinal tubules→a pressure change→Aδ intradentinal nerves(pulp-dentinal interface or within the dentinal tubules)→pain

  5. causes text1 text2 text3 tooth brushing diet acid age attrition abrasion erosion loss of enamel or periodontal tissue

  6. Diagnosis 1)one investigator 2)should be calibrated - ideally 3)initialstimulus should be as low as possible 4)gradual escalation to the threshold level 5)repeated after some timeto obtain an average ofvalues

  7. Diagnosis Mechanical (tactile) stimuli: 1)a sharp-tipped probe 2)mechanicalpressure stimulators 3)Yeaple probe ps:Periodontal probes→variability(no) perpendicularscratch,graduallyincreased, no to over Yeaple probe:the applied force is increased in 5-g steps until 70g

  8. Diagnosis Cold air currents: environmental temperature of 19-24ºC a pressure of 45 psi at a distance of 1 cm perpendicular to the surface one second the screening and initial selection of teeth and subjectsdestined for study

  9. Diagnosis If tactile and thermal stimuli are jointly employed in onesame individual, the tactile stimulus generally should beapplied first to avoid doubts as to whether he pain producedafter thermal stimulation is due to the low temperatureor to dehydration induced by the air current

  10. Diagnosis Chemical (osmotic) stimuli: hypertonic solutions of glucose and sucrose Acid solutions→low pH→demineralization(no) a cotton stick during10 seconds osmotic pressures→intratubular fluid notadvised difficulty of controlling theresponse obtained

  11. Methods for evaluating response after stimulation Verbal rating scale (VRS): The patient uses a numerical code from 0 to 3 to rate perceivedsensation 0 = no discomfort 1 = mild discomfort 2= important discomfort 3 = important discomfort lastingmore than 10 seconds only these few options,no detailed description

  12. Methods for evaluating response after stimulation Visual analog scale (VAS): 10-cm straight line 0 = no pain 10 = extreme, unbearable pain practical and useful does not distinguishbetween the sensory and affective components of pain

  13. treatment productions therapeutic products self-applied products professional use

  14. treatment productions adequate counseling on foods patients with low or mild sensitivity the prescription of desensitizing toothpastes and/or oral rinses occluding the dentinal tubules (strontium salts, oxalates or fluoridatedagents) or agents capable of modulating nerve excitability (potassium salts)

  15. treatment productions moderate intensity DS high- concentration fluoridated varnish or lacquer can offer good results

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